Joint Injections Explained

At Invicta we have a specialist physiotherapy service that enables us to perform different types of joint injections on site. We use an ultrasound guided approach when necessary to ensure a safe, accurate and successful intervention to help manage an inflamed joint or painful joint. Our injection services include:

• Point Of Care Ultrasound (POCUS)
• Arthrosamid®
• Corticosteroids
• Ostenil® / Hyaluronic Acid
• Hydrodilitation For Frozen Shoulder
• Joint Aspirations
• Prolotherapy
• Advanced Techniques

Please note – we are unable to perform injections into the spine.

Why Choose Invicta Clinic for Joint Injections? 

Our practitioners have a wealth of experience in NHS, private practice, and professional sports environments where referrals for injections are not uncommon to improve a patients pain, function, and quality of life. Joint injections are always clinically reasoned following accurate diagnosis and performed alongside effective physiotherapy as part of a comprehensive management plan. We perform all of our injections under ultrasound guidance to ensure accurate, safe and effective treatment.

Point Of Care Ultrasound (POCUS)

At Invicta Health & Performance, our trained clinical specialist physiotherapist offers musculoskeletal ultrasound scans (POCUS) as part of your Pre-Injection Consultation. This scan helps identify issues with muscles, tendons, ligaments, and certain bone surfaces, complementing your clinical history and physical examination to support accurate diagnosis and effective management.

What to Expect

Your appointment will involve a thorough medical history and physical assessment, including the ultrasound scan. The scan can detect structural issues in superficial soft tissues, but has limitations, especially with deeper structures within the joint or where the injury site is covered by excessive fat mass. Please note, we do not assess the face, neck, spine, trunk, or pelvis with ultrasound.

What If the Scan is Normal?

Sometimes, pain may occur even without structural abnormalities visible on the scan. If this happens, your clinician will discuss next steps, which could include further physio, injections, tests or referrals.

Lumps and Bumps

Our musculoskeletal ultrasound does not assess lumps, bumps, or vascular abnormalities like DVT. If you have concerns in these areas, you will be referred to the appropriate specialist.

Image Storage & Reports

Images from your scan will be securely stored and are part of your clinical records. With your consent, they may be included in reports or shared with you upon request. For any questions or to book your scan, please contact us at info@invictahealthandperformance.com

• 1 Area (45min) = £100
• 2 Areas (60min) = £150
• 3 Areas (75min) = £175

Arthrosamid 

Invicta are registered providers of Arthrosamid® which is a new and innovative type of treatment for knee osteoarthritis that offers patients an effective alternative to the currently available therapies and even surgery. Based on cutting edge hydrogel technology, Arthrosamid® is 2.5% cross-linked polyacrylamide and 97.5% water. The injections work by attaching onto the synovial lining of the joint, restoring viscosity within the synovial fluid, lubricating, and cushioning the joint. It also acts to stop the dysregulated cycle of inflammation that is often the pain driver for a lot of osteoarthritis patients.

Clinical research has shown Arthrosamid treatment to be effective at reducing pain and improving joint function long term. This treatment is a non-biodegradable single-dose injection that delivers safe, long-acting, and sustained pain relief, improving the quality of life for patients with knee osteoarthritis. 

Key benefits of Arthrosamid include:

1. Long-Lasting Pain Relief: Arthrosamid is designed to provide long-term pain relief by cushioning the joint and reducing friction between the bones. It offers relief to patients with moderate to severe knee osteoarthritis, even in cases where other treatments may have failed.
2. Improves Joint Function: By acting as a lubricant, Arthrosamid improves the biomechanics of the knee joint, allowing for greater mobility and flexibility in patients suffering from osteoarthritis. It helps patients regain daily functionality and may support more active lifestyles.
3. Non-Surgical Option: Arthrosamid offers a minimally invasive alternative to knee surgery. It is delivered through a single injection directly into the knee joint and does not require anesthesia or extensive recovery times, making it an attractive option for people avoiding surgery.
4. Biocompatibility and Safety: Arthrosamid is made of a non-resorbable, biocompatible hydrogel that integrates with the body’s natural tissues. It is generally well-tolerated and carries fewer risks compared to invasive surgical procedures.
5. Minimal Side Effects: Side effects with Arthrosamid are typically mild and localized, such as temporary discomfort at the injection site. Unlike some other treatments (e.g., steroid injections), it avoids systemic effects and has a lower risk of complications.
6. Long-Lasting Effects: Studies show that a single Arthrosamid injection can provide significant relief for up to two years, reducing the need for repeated injections.
7. Improves Quality of Life: By reducing pain and improving mobility, Arthrosamid can enhance overall quality of life. Patients may experience less difficulty with daily tasks, increased participation in physical activities, and improved mental well-being due to better physical health.

By offering sustained pain relief and improved mobility, Arthrosamid® is reshaping how knee OA is treated. For those seeking non-surgical options, it can be a valuable alternative, especially when other treatments are insufficient. Response rates are promising with Arthrosamid treatment for arthritic knee pain. Patients in the under 70 years group report close to 80% positive response rate following treatment.

For more information on how Arthrosamid® is becoming the forefront of injectable management options for osteoarthritis please visit Arthrosamid. See below for the cost of Arthrosamid injection.

Arthrosamid Price: 

Arthrosamid® injection: £2850  

Arthrosamid® injection: £5200 [both knees – £500 Saving]

Corticosteroids Injections

Cortisone injections are a powerful treatment for joint pain, offering rapid relief by reducing inflammation directly at the source. Many patients experience significant pain reduction only days after the injection, making it a quick and effective option for conditions like osteoarthritis, bursitis and some tendinopathies.

Key benefits of Corticosteroids include:

1. Rapid Pain Relief: Corticosteroid injections often provide quick relief from joint pain and inflammation, sometimes within 24 to 48 hours, making them highly effective for acute flare-ups.
2. Reduction of Inflammation: By directly targeting inflammation within the joint, corticosteroids reduce swelling, stiffness, and warmth, which are common in conditions like osteoarthritis, rheumatoid arthritis, and gout.
3. Improved Mobility: With reduced pain and inflammation, patients often experience improved joint function and greater range of motion, allowing them to perform daily activities more comfortably.
4. Localized Treatment: Because the medication is injected directly into the affected joint, corticosteroid injections offer targeted relief without affecting the whole body, minimizing systemic side effects.
5. Non-Surgical Option: For many patients, corticosteroid injections can delay or prevent the need for surgery, particularly in degenerative joint diseases or repetitive strain injuries.
6. Reduction in Use of Oral Medications: Since corticosteroid injections can offer long-lasting relief (up to several months), patients may reduce or avoid the use of oral pain medications (e.g., NSAIDs), which can have gastrointestinal or cardiovascular side effects.
7. Minimal Downtime: The procedure is quick, minimally invasive, and allow patients to return to their normal activities with minimal downtime.
8. Useful in Diagnosing Joint Issues: Sometimes, corticosteroid injections are used diagnostically. If the pain improves significantly after the injection, it confirms that inflammation in the joint is the cause of the discomfort.

Through fast pain relief, cortisone helps indirectly improve mobility and function, allowing individuals to resume daily activities or participate in physical therapy more comfortably. The anti inflammatory effects of the injection can be felt immediately short term but can last for prolonged periods, providing long-lasting relief without the need for systemic medications. These injections can be used in conjunction with other treatments like physiotherapy for better overall joint health. While not a cure, cortisone injections offer a targeted and effective solution to help manage chronic pain, inflammation and degenerative arthritis improving quality of life for many. We use an ultrasound guided approach to all injections to ensure a safe, accurate and successful intervention to manage your condition.

Prices: 

Ultrasound guided corticosteroid injection: £250

Ultrasound guided corticosteroid injection: £400 [two locations]

Ostenil / Hyaluronic Acid Injections 

Ostenil®️ Plus is a solution containing hyaluronic acid. In orthopaedic medicine, hyaluronic acid is used as a treatment for osteoarthritis, particularly in the knee.

The key benefits of Ostenil include:

1. Minimally Invasive: Hyaluronic acid injections are a non-surgical option compared to joint replacement procedures.
2. Lubricates Joints: Hyaluronic acid injections provide lubrication for joints, improving joint function and reducing friction during movement.
3. Reduces Pain: By enhancing joint lubrication and cushioning, it can relieve pain associated with osteoarthritis, allowing better mobility.
4. Slows Disease Progression: In some cases, hyaluronic acid can slow down the deterioration of cartilage in the joints, delaying the need for surgical interventions.

It is injected into the space in the joint that contains synovial fluid and works by restoring and promoting an optimal fluid environment inside the joint. This can result in pain relief when conventional therapy is failing or corticosteroid treatment is not appropriate. The addition of Mannitol (a simple sugar derivative) to Ostenil®️ allows the Hyaluronic Acid to work for longer and more efficiently in the joint, enabling effective symptom reduction with a single injection. 

Ostenil®️ has been extensively tested and has not been found to cause any serious side effects. Because hyaluronic acid is a naturally occurring substance in the body there’s a low risk of allergic reactions or side effects. Hyaluronic acid injections are widely regarded as safe when administered by qualified professionals, with minimal downtime and significant benefits for joint pain patients suffering from osteoarthritis. Ostenil ®️ can be injected alongside Corticosteroids to maximise the effectiveness of treatment in some cases.

Prices: 

Ostenil®️ Plus Injection: £275

Ostenil®️ Plus + Steroid Injection: £400

Hydrodilitation for Frozen Shoulder

Hydrodilitation is a minimally invasive procedure used to treat frozen shoulder (adhesive capsulitis), a condition where the shoulder joint becomes stiff and painful due to inflammation and tightening of the capsule surrounding the joint. During hydrodilitation, a mixture of local anaesthetic, saline and corticosteroid is injected into the shoulder joint to stretch the capsule and reduce inflammation.

Key Benefits of Hydrodilitation for Frozen Shoulder:

1. Improved Range of Motion: The injection of fluid expands the shoulder joint capsule, stretching the tight tissues and allowing for an increased range of motion. This can lead to quicker improvements in shoulder mobility compared to other conservative treatments.
2. Pain Relief: The corticosteroids in the injection reduce inflammation, which helps to alleviate pain. Many patients experience rapid relief from the discomfort associated with frozen shoulder after the procedure.
3. Minimally Invasive: Hydrodilatation is a non-surgical, outpatient procedure performed under local anesthesia or sedation. It carries fewer risks and has a shorter recovery time compared to more invasive treatments like shoulder surgery.
4. Short Procedure Time: The procedure usually takes about 15 to 30 minutes, and patients can go home the same day. Physical therapy may be started soon after to maintain the improved mobility.
5. Quick Recovery: Patients often notice improvements in shoulder function within days or weeks following hydrodilatation, especially when combined with physiotherapy.
6. Reduces the Need for Surgery: For many patients, hydrodilatation can delay or prevent the need for more invasive procedures like arthroscopic surgery by effectively treating symptoms in earlier stages.
7. Improved Outcomes with Physical Therapy: Hydrodilitation often makes it easier for patients to engage in physical therapy by reducing pain and increasing range of motion, which is essential for long-term recovery from frozen shoulder.

Patients in the early to middle stages of frozen shoulder, where the joint stiffness and pain are most prominent, often benefit the most from hydrodilitation. However, for individuals with more advanced cases or where conservative treatments have failed, it may be a valuable option before considering surgery. The procedure is performed under ultrasound guidance to ensure that the injection is accurately placed within the shoulder joint. Frozen Shoulder is often slow to resolve and highly irritable for those patients who suffer from it. A hydrodilitation injection combined with intensive physiotherapy can result in improved recovery timelines and a restoration of function. Nationally, there is a success rate of over 70% in improving shoulder movement and over 90% in improving pain.

Price: 

Hydrodilitation with Corticosteroid Injection: £450

Joint Aspirations

It is common for acute and chronic joint injuries to be associated with a lot of swelling and pain which is often the case at the knee and ankle. Inflammation is a necessary bodily response to injury and healing but excessive and stubborn long standing amounts can be detrimental to function and long term joint health.

Using ultrasound guidance we can inject a needle into the cavity of a joint and using a syringe can draw out any excessive effusion (swelling) sitting internally. This can range from 5ml to 150ml of fluid and is associated with an immediate improvement in pain and function when done alongside a corticosteroid injection. Joint aspirations are sometimes a necessary procedure prior to receiving an injection to decrease joint swelling and improve pain, functional outcomes and quality of life.

Prices: 

Joint Aspirations: £100

Prolotherapy

Prolotherapy is a minimally invasive treatment that promotes natural healing in damaged tissues, offering a non-surgical solution for chronic pain, joint instability, and musculoskeletal injuries. By injecting a solution, often dextrose mixed with an anesthetic, into weakened ligaments or tendons, prolotherapy stimulates the body’s natural healing response.

Key Benefits of Prolotherapy:

1. Natural Healing: Encourages the body to repair damaged tissues by stimulating collagen production, strengthening ligaments and tendons.
2. Long-Lasting Pain Relief: Effective for chronic joint and tendon pain, providing relief by restoring tissue health and function.
3. Improved Joint Stability: Strengthens joints, improving mobility and reducing the risk of recurrent injury.
4. Minimally Invasive: Offers a non-surgical, outpatient option with minimal downtime.
5. Versatile Treatment: Addresses a variety of conditions like osteoarthritis, tendonitis, and back pain.

Prolotherapy may be ideal for those seeking a natural, long-term solution to pain without the need for surgery. For optimal outcomes, these injections are usually performed as a series of 2-3 injections spaced across 2-4 weeks.

Prices:

Prolotherapy Injection: £250

Prolotherapy Injections [Series of 3]: £625

Advanced Techniques

Barbotage

Barbotage is a minimally invasive medical procedure used to treat calcific tendinitis, a condition where calcium deposits accumulate in the tendons, most commonly in the shoulder. During the procedure, a small needle is inserted into the affected area, and the calcium deposits are broken up by injecting and withdrawing saline (a technique known as lavage). The goal is to dissolve or loosen the calcium, allowing it to be absorbed by the body or removed. This helps reduce pain and improve mobility, often as part of a broader rehabilitation plan.

Fenestration

The fenestration technique is a therapeutic approach used primarily in soft tissue treatments, particularly for chronic tendon or ligament injuries. It involves making small, controlled punctures in the injured tissue with a needle. These micro-punctures stimulate a healing response by increasing blood flow to the area, promoting tissue regeneration and reducing chronic inflammation. The technique is often used in conjunction with other therapies like dry needling or PRP (platelet-rich plasma) injections, aiding recovery and pain relief in conditions such as tendinopathy or ligament injuries.

Price:

Advanced Techniques: Additional £50

Take Note

At Invicta we aim to improve your symptoms and function through quality assessment, treatment, rehabilitation, and injury management advice. We only make referrals for adjunct injections if this is clinically reasoned, and other conventional management approaches are unsuccessful.

To see if you would benefit from any of the above injections you will need to book a face-to-face or telephone consultation with one of our experienced physiotherapists. As a result, you cannot directly book an appointment for an injection. If you want to speak to us about a joint injection or have questions regarding your management, please contact us here.